NSG 6998 PRE-PREDICTOR EXAM 2026 –
PRACTICE QUESTIONS & VERIFIED
ANSWERS STUDY GUIDE
• This study guide is designed to help you actively recall, self-test, and reinforce core
nursing concepts — read each question carefully before checking the answer, and
always review the EXPERT RATIONALE even when you get it right.
• Each question includes five answer choices, a bolded correct answer, and a
detailed EXPERT RATIONALE to deepen your understanding and build clinical
reasoning for the predictor exam.
1. A nurse is caring for a client with heart failure who has crackles bilaterally,
3+ pitting edema, and a SpO₂ of 88%. Which intervention is the priority?
A. Administer a scheduled oral potassium supplement
B. Reposition the client to the left lateral position
C. Encourage the client to increase oral fluid intake
D. Elevate the head of the bed and apply supplemental oxygen
E. Obtain a 12-lead ECG immediately
✓ Correct Answer: D. Elevate the head of the bed and apply supplemental
oxygen
EXPERT RATIONALE: The client is hypoxic (SpO₂ 88%) and showing signs of pulmonary
edema. Elevating the HOB reduces venous return and improves lung expansion while
supplemental oxygen corrects hypoxia. Airway and oxygenation are always the first
priority per ABCs.
2. A client with chronic kidney disease has a serum potassium of 6.4 mEq/L.
Which finding requires the nurse's immediate attention?
A. Blood pressure of 148/90 mmHg
B. Urine output of 35 mL/hour
,C. Peaked T-waves on ECG monitor
D. Serum sodium of 136 mEq/L
E. Mild generalized weakness
✓ Correct Answer: C. Peaked T-waves on ECG monitor
EXPERT RATIONALE: Peaked T-waves are an early cardiac manifestation of hyperkalemia
and can progress to fatal dysrhythmias. This finding requires immediate intervention.
Cardiac changes take priority over the other listed findings in a hyperkalemic client.
3. A nurse is teaching a client newly diagnosed with type 2 diabetes about
foot care. Which statement by the client indicates a need for further
teaching?
A. "I will inspect my feet every day."
B. "I will wear well-fitting shoes at all times."
C. "I will soak my feet in hot water to soften calluses."
D. "I will not walk barefoot."
E. "I will report any cuts or sores to my doctor right away."
✓ Correct Answer: C. "I will soak my feet in hot water to soften calluses."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
because peripheral neuropathy reduces sensation, increasing the risk of burns. Clients
should wash feet in lukewarm water and dry thoroughly between toes.
4. A postoperative client reports pain of 8/10 and has an order for morphine IV
PRN. Before administering the medication, what is the priority nursing
assessment?
A. Blood pressure
B. Heart rate
,C. Respiratory rate
D. Temperature
E. Oxygen saturation via pulse oximetry
✓ Correct Answer: C. Respiratory rate
EXPERT RATIONALE: Opioids such as morphine cause respiratory depression as their
most dangerous side effect. The nurse must assess respiratory rate prior to
administration and withhold the medication if the rate is below 12 breaths/minute.
5. A nurse is reviewing lab results for a client on warfarin therapy. Which
result would prompt the nurse to hold the medication and notify the
provider?
A. INR of 1.5
B. PT of 12 seconds
C. INR of 4.8
D. aPTT of 60 seconds
E. Platelet count of 200,000/mm³
✓ Correct Answer: C. INR of 4.8
EXPERT RATIONALE: The therapeutic INR for warfarin therapy is typically 2.0–3.0 (or up
to 3.5 for mechanical heart valves). An INR of 4.8 indicates the client is excessively
anticoagulated and at serious risk for bleeding, requiring the medication to be held and
the provider notified.
6. A nurse is caring for a client in active labor whose fetal heart rate (FHR)
tracing shows late decelerations with every contraction. What is the priority
nursing action?
A. Increase the rate of oxytocin infusion
B. Document the findings and continue monitoring
, C. Reposition the client to the left lateral position
D. Prepare for immediate cesarean delivery
E. Perform a vaginal examination
✓ Correct Answer: C. Reposition the client to the left lateral position
EXPERT RATIONALE: Late decelerations indicate uteroplacental insufficiency. The priority
intervention is to reposition to the left lateral position to relieve aortocaval compression
and improve placental blood flow. Oxygen should also be applied. Oxytocin should be
discontinued, not increased.
7. A client with schizophrenia tells the nurse, "The television is sending me
special messages about my mission." How should the nurse respond?
A. "That's interesting. What kind of messages?"
B. "The TV cannot send messages specifically to you."
C. "I understand you believe that, but I do not see it that way."
D. "Let's change the channel so the messages stop."
E. "You are having a hallucination. This is not real."
✓ Correct Answer: C. "I understand you believe that, but I do not see it that
way."
EXPERT RATIONALE: This response acknowledges the client's experience without
reinforcing or arguing against the delusion. It maintains therapeutic rapport while gently
presenting reality. Arguing with or agreeing with delusions is non-therapeutic.
8. A nurse is preparing to administer digoxin to a client. Which assessment
finding would cause the nurse to hold the medication?
A. Apical heart rate of 68 bpm
B. Serum potassium of 3.0 mEq/L
PRACTICE QUESTIONS & VERIFIED
ANSWERS STUDY GUIDE
• This study guide is designed to help you actively recall, self-test, and reinforce core
nursing concepts — read each question carefully before checking the answer, and
always review the EXPERT RATIONALE even when you get it right.
• Each question includes five answer choices, a bolded correct answer, and a
detailed EXPERT RATIONALE to deepen your understanding and build clinical
reasoning for the predictor exam.
1. A nurse is caring for a client with heart failure who has crackles bilaterally,
3+ pitting edema, and a SpO₂ of 88%. Which intervention is the priority?
A. Administer a scheduled oral potassium supplement
B. Reposition the client to the left lateral position
C. Encourage the client to increase oral fluid intake
D. Elevate the head of the bed and apply supplemental oxygen
E. Obtain a 12-lead ECG immediately
✓ Correct Answer: D. Elevate the head of the bed and apply supplemental
oxygen
EXPERT RATIONALE: The client is hypoxic (SpO₂ 88%) and showing signs of pulmonary
edema. Elevating the HOB reduces venous return and improves lung expansion while
supplemental oxygen corrects hypoxia. Airway and oxygenation are always the first
priority per ABCs.
2. A client with chronic kidney disease has a serum potassium of 6.4 mEq/L.
Which finding requires the nurse's immediate attention?
A. Blood pressure of 148/90 mmHg
B. Urine output of 35 mL/hour
,C. Peaked T-waves on ECG monitor
D. Serum sodium of 136 mEq/L
E. Mild generalized weakness
✓ Correct Answer: C. Peaked T-waves on ECG monitor
EXPERT RATIONALE: Peaked T-waves are an early cardiac manifestation of hyperkalemia
and can progress to fatal dysrhythmias. This finding requires immediate intervention.
Cardiac changes take priority over the other listed findings in a hyperkalemic client.
3. A nurse is teaching a client newly diagnosed with type 2 diabetes about
foot care. Which statement by the client indicates a need for further
teaching?
A. "I will inspect my feet every day."
B. "I will wear well-fitting shoes at all times."
C. "I will soak my feet in hot water to soften calluses."
D. "I will not walk barefoot."
E. "I will report any cuts or sores to my doctor right away."
✓ Correct Answer: C. "I will soak my feet in hot water to soften calluses."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
because peripheral neuropathy reduces sensation, increasing the risk of burns. Clients
should wash feet in lukewarm water and dry thoroughly between toes.
4. A postoperative client reports pain of 8/10 and has an order for morphine IV
PRN. Before administering the medication, what is the priority nursing
assessment?
A. Blood pressure
B. Heart rate
,C. Respiratory rate
D. Temperature
E. Oxygen saturation via pulse oximetry
✓ Correct Answer: C. Respiratory rate
EXPERT RATIONALE: Opioids such as morphine cause respiratory depression as their
most dangerous side effect. The nurse must assess respiratory rate prior to
administration and withhold the medication if the rate is below 12 breaths/minute.
5. A nurse is reviewing lab results for a client on warfarin therapy. Which
result would prompt the nurse to hold the medication and notify the
provider?
A. INR of 1.5
B. PT of 12 seconds
C. INR of 4.8
D. aPTT of 60 seconds
E. Platelet count of 200,000/mm³
✓ Correct Answer: C. INR of 4.8
EXPERT RATIONALE: The therapeutic INR for warfarin therapy is typically 2.0–3.0 (or up
to 3.5 for mechanical heart valves). An INR of 4.8 indicates the client is excessively
anticoagulated and at serious risk for bleeding, requiring the medication to be held and
the provider notified.
6. A nurse is caring for a client in active labor whose fetal heart rate (FHR)
tracing shows late decelerations with every contraction. What is the priority
nursing action?
A. Increase the rate of oxytocin infusion
B. Document the findings and continue monitoring
, C. Reposition the client to the left lateral position
D. Prepare for immediate cesarean delivery
E. Perform a vaginal examination
✓ Correct Answer: C. Reposition the client to the left lateral position
EXPERT RATIONALE: Late decelerations indicate uteroplacental insufficiency. The priority
intervention is to reposition to the left lateral position to relieve aortocaval compression
and improve placental blood flow. Oxygen should also be applied. Oxytocin should be
discontinued, not increased.
7. A client with schizophrenia tells the nurse, "The television is sending me
special messages about my mission." How should the nurse respond?
A. "That's interesting. What kind of messages?"
B. "The TV cannot send messages specifically to you."
C. "I understand you believe that, but I do not see it that way."
D. "Let's change the channel so the messages stop."
E. "You are having a hallucination. This is not real."
✓ Correct Answer: C. "I understand you believe that, but I do not see it that
way."
EXPERT RATIONALE: This response acknowledges the client's experience without
reinforcing or arguing against the delusion. It maintains therapeutic rapport while gently
presenting reality. Arguing with or agreeing with delusions is non-therapeutic.
8. A nurse is preparing to administer digoxin to a client. Which assessment
finding would cause the nurse to hold the medication?
A. Apical heart rate of 68 bpm
B. Serum potassium of 3.0 mEq/L
